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Stanwick M, Fenesha F, Hamid A, Kang K, Kanniard D, Kim I, Mandarano N, Schumacher FL, Peters SB. Impaired Tertiary Dentin Secretion after Shallow Injury in Tgfbr2-Deficient Dental Pulp Cells Is Rescued by Extended CGRP Signaling. Int J Mol Sci 2024; 25:6847. [PMID: 38999956 PMCID: PMC11241056 DOI: 10.3390/ijms25136847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 06/10/2024] [Accepted: 06/14/2024] [Indexed: 07/14/2024] Open
Abstract
The transforming growth factor β (TGFβ) superfamily is a master regulator of development, adult homeostasis, and wound repair. Dysregulated TGFβ signaling can lead to cancer, fibrosis, and musculoskeletal malformations. We previously demonstrated that TGFβ receptor 2 (Tgfbr2) signaling regulates odontoblast differentiation, dentin mineralization, root elongation, and sensory innervation during tooth development. Sensory innervation also modulates the homeostasis and repair response in adult teeth. We hypothesized that Tgfbr2 regulates the neuro-pulpal responses to dentin injury. To test this, we performed a shallow dentin injury with a timed deletion of Tgfbr2 in the dental pulp mesenchyme of mice and analyzed the levels of tertiary dentin and calcitonin gene-related peptide (CGRP) axon sprouting. Microcomputed tomography imaging and histology indicated lower dentin volume in Tgfbr2cko M1s compared to WT M1s 21 days post-injury, but the volume was comparable by day 56. Immunofluorescent imaging of peptidergic afferents demonstrated that the duration of axon sprouting was longer in injured Tgfbr2cko compared to WT M1s. Thus, CGRP+ sensory afferents may provide Tgfbr2-deficient odontoblasts with compensatory signals for healing. Harnessing these neuro-pulpal signals has the potential to guide the development of treatments for enhanced dental healing and to help patients with TGFβ-related diseases.
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Affiliation(s)
- Monica Stanwick
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA; (M.S.); (F.F.); (A.H.); (K.K.); (D.K.); (I.K.)
| | - Fatma Fenesha
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA; (M.S.); (F.F.); (A.H.); (K.K.); (D.K.); (I.K.)
| | - Ahmed Hamid
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA; (M.S.); (F.F.); (A.H.); (K.K.); (D.K.); (I.K.)
| | - Khushroop Kang
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA; (M.S.); (F.F.); (A.H.); (K.K.); (D.K.); (I.K.)
| | - Dane Kanniard
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA; (M.S.); (F.F.); (A.H.); (K.K.); (D.K.); (I.K.)
| | - Irene Kim
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA; (M.S.); (F.F.); (A.H.); (K.K.); (D.K.); (I.K.)
| | - Nicholas Mandarano
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH 43210, USA; (N.M.); (F.L.S.)
| | - Fernanda L. Schumacher
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH 43210, USA; (N.M.); (F.L.S.)
| | - Sarah B. Peters
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH 43210, USA; (N.M.); (F.L.S.)
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Wu J, Li J, Mao S, Li B, Zhu L, Jia P, Huang G, Yang X, Xu L, Qiu D, Wang S, Dong Y. Heparin-Functionalized Bioactive Glass to Harvest Endogenous Growth Factors for Pulp Regeneration. ACS APPLIED MATERIALS & INTERFACES 2024; 16:30715-30727. [PMID: 38833722 DOI: 10.1021/acsami.4c03118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
Pulp and periapical diseases can lead to the cessation of tooth development, resulting in compromised tooth structure and functions. Despite numerous efforts to induce pulp regeneration, effective strategies are still lacking. Growth factors (GFs) hold considerable promise in pulp regeneration due to their diverse cellular regulatory properties. However, the limited half-lives and susceptibility to degradation of exogenous GFs necessitate the administration of supra-physiological doses, leading to undesirable side effects. In this research, a heparin-functionalized bioactive glass (CaO-P2O5-SiO2-Heparin, abbreviated as PSC-Heparin) with strong bioactivity and a stable neutral pH is developed as a promising candidate to addressing challenges in pulp regeneration. Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy, and thermogravimetric analysis reveal the successful synthesis of PSC-Heparin. Scanning electron microscopy and X-ray diffraction show the hydroxyapatite formation can be observed on the surface of PSC-Heparin after soaking in simulated body fluid for 12 h. PSC-Heparin is capable of harvesting various endogenous GFs and sustainably releasing them over an extended duration by the enzyme-linked immunosorbent assay. Cytological experiments show that developed PSC-Heparin can facilitate the adhesion, migration, proliferation, and odontogenic differentiation of stem cells from apical papillae. Notably, the histological analysis of subcutaneous implantation in nude mice demonstrates PSC-Heparin is capable of promoting the odontoblast-like layers and pulp-dentin complex formation without the addition of exogenous GFs, which is vital for clinical applications. This work highlights an effective strategy of harvesting endogenous GFs and avoiding the involvement of exogenous GFs to achieve pulp-dentin complex regeneration, which may open a new horizon for regenerative endodontic therapy.
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Affiliation(s)
- Jilin Wu
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
| | - Jingyi Li
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
| | - Sicong Mao
- Department of General Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
| | - Baokui Li
- Beijing National Laboratory for Molecular Sciences, Laboratory of Polymer Physics and Chemistry CAS Research/Education Center for Excellence in Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, China
- School of Chemical Sciences, University of Chinese Academy of Sciences, Beijing 10090, China
| | - Lin Zhu
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Peipei Jia
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Guibin Huang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Xule Yang
- Beijing National Laboratory for Molecular Sciences, Laboratory of Polymer Physics and Chemistry CAS Research/Education Center for Excellence in Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, China
| | - Liju Xu
- Beijing National Laboratory for Molecular Sciences, Laboratory of Polymer Physics and Chemistry CAS Research/Education Center for Excellence in Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, China
- School of Chemical Sciences, University of Chinese Academy of Sciences, Beijing 10090, China
| | - Dong Qiu
- Beijing National Laboratory for Molecular Sciences, Laboratory of Polymer Physics and Chemistry CAS Research/Education Center for Excellence in Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, China
- School of Chemical Sciences, University of Chinese Academy of Sciences, Beijing 10090, China
| | - Sainan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
| | - Yanmei Dong
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
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Reis-Prado AHD, Toledo PTA, Nunes GP, Ferreira PAV, Rahimnejad M, Dal-Fabbro R, Abreu LG, Bottino MC, Benetti F. Citric Acid Conditioning as an Alternative to EDTA for Growth Factors Release and Stem Cell Response in Regenerative Endodontics: A Systematic Review of In Vitro Studies. J Endod 2024; 50:129-143. [PMID: 37984798 DOI: 10.1016/j.joen.2023.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/11/2023] [Accepted: 11/13/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION Citric acid (CA) conditioning may be a promising alternative to ethylenediaminetetraacetic acid (EDTA) in regenerative endodontic procedures, as reported to improve growth factors' release from dentin. This review systematically investigated the effect of CA conditioning on the growth factors release from dentin and cell behavior compared to EDTA conditioning. METHODS Searches were conducted (PubMed/MEDLINE, Scopus, Web of Science, Embase, SciELO, Cochrane Library, and grey literature) until May-2023. Only in vitro studies that evaluated the effects of CA on growth factors' release from dentin and cell behavior outcomes compared to EDTA were included. The studies were critically appraised using a modified Joanna Briggs Institute's checklist. Meta-analysis was unfeasible. RESULTS Out of the 335 articles screened, nine were included. Among these, three studies used dentin discs/roots from permanent human teeth; the rest combined them with stem cells. 10% CA for 5 or 10 minute was the most used protocol. Meanwhile, EDTA concentrations ranged from 10% to 17%. In eight studies examining the release of growth factors, five reported a significant release of transforming growth factor-β after dentin conditioning with 10% CA compared to 17% EDTA. Regarding cell behavior (6 studies), three studies assessed cell viability. The findings revealed that 10% CA conditioning showed cell viability similar to those of 17% EDTA. Additionally, in two out of three studies, it was observed that 10% CA conditioning did not affect cell morphology. The studies had a low risk of bias. CONCLUSIONS The use of 10% CA to condition dentin for 5-10 minutes resulted in a notable transforming growth factor -β1 release, but its cell responses were similar to those of EDTA.
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Affiliation(s)
- A H Dos Reis-Prado
- Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, Minas Gerais, Brazil; Cariology, Restorative Sciences and Endodontics, University of Michigan, School of Dentistry, Ann Arbor, Michigan
| | - P T A Toledo
- Cariology, Restorative Sciences and Endodontics, University of Michigan, School of Dentistry, Ann Arbor, Michigan; Preventive and Restorative Dentistry, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - G P Nunes
- Laboratory for Bone Metabolism and Regeneration, University of Porto, Faculty of Dental Medicine, Porto, Portugal
| | - P A V Ferreira
- Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, Minas Gerais, Brazil
| | - M Rahimnejad
- Cariology, Restorative Sciences and Endodontics, University of Michigan, School of Dentistry, Ann Arbor, Michigan
| | - R Dal-Fabbro
- Cariology, Restorative Sciences and Endodontics, University of Michigan, School of Dentistry, Ann Arbor, Michigan
| | - L G Abreu
- Child's and Adolescent's Oral Health, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, Minas Gerais, Brazil
| | - M C Bottino
- Cariology, Restorative Sciences and Endodontics, University of Michigan, School of Dentistry, Ann Arbor, Michigan
| | - F Benetti
- Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, Minas Gerais, Brazil.
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Bai Y, Liu X, Li J, Wang Z, Guo Q, Xiao M, Cooper PR, Yu Q, He W. Stage-Dependent Regulation of Dental Pulp Stem Cell Odontogenic Differentiation by Transforming Growth Factor- β1. Stem Cells Int 2022; 2022:2361376. [PMID: 36338026 PMCID: PMC9629931 DOI: 10.1155/2022/2361376] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 09/21/2022] [Accepted: 09/29/2022] [Indexed: 10/12/2023] Open
Abstract
Transforming growth factor-β1 (TGF-β1) is an important multifunctional cytokine with dual effects on stem cell differentiation. However, the role of TGF-β1 on odontogenic differentiation of dental pulp stem cells (DPSCs) remains to be entirely elucidated. In the present study, we initially investigated the effect of TGF-β1 at a range of concentrations (0.1-5 ng/mL) on the proliferation, cell cycle, and apoptosis of DPSCs. Subsequently, to determine the effect of TGF-β1 on odontogenic differentiation, alkaline phosphatase (ALP) activity and Alizarin Red S (ARS) staining assays at different concentrations and time points were performed. Quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot analysis were used to determine the levels of odonto-/osteo-genic differentiation-related gene and protein expression, respectively. For in vivo studies, newly formed tissue was assessed by Masson's trichrome and von Kossa staining. Data indicated that TGF-β1 inhibited DPSCs proliferation in a concentration-and time-dependent manner (p < 0.05) and induced cell cycle arrest but did not affect apoptosis. ALP activity was enhanced, while ARS reduced gradually with increasing TGF-β1 concentrations, accompanied by increased expression of early marker genes of odonto-/osteo-genic differentiation and decreased expression of late-stage mineralization marker genes (p < 0.05). ALP expression was elevated in the TGF-β1-treatment group until 14 days, and the intensity of ARS staining was attenuated at days 14 and 21 (p < 0.05). Compared with the control group, abundant collagen but no mineralized tissues were observed in the TGF-β1-treatment group in vivo. Overall, these findings indicate that TGF-β1 promotes odontogenic differentiation of DPSCs at early-stage while inhibiting later-stage mineralization processes.
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Affiliation(s)
- Yu Bai
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, Air Force Medical University, 145 Changle Road, Xi'an 710032, China
| | - Xin Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, Air Force Medical University, 145 Changle Road, Xi'an 710032, China
| | - Junqing Li
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, Air Force Medical University, 145 Changle Road, Xi'an 710032, China
- Hospital of Stomatology, Zunyi Medical University, 89 Wu-jiang Dong Road, Zunyi 563003, China
| | - Zhihua Wang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, Air Force Medical University, 145 Changle Road, Xi'an 710032, China
| | - Qian Guo
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, Air Force Medical University, 145 Changle Road, Xi'an 710032, China
| | - Min Xiao
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, Air Force Medical University, 145 Changle Road, Xi'an 710032, China
| | - Paul R. Cooper
- Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Qing Yu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, Air Force Medical University, 145 Changle Road, Xi'an 710032, China
| | - Wenxi He
- Department of Stomatology, Air Force Medical Center, Air Force Medical University, 30 Fucheng Road, Beijing 100142, China
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Regenerative Endodontics by Cell Homing: A Review of Recent Clinical trials. J Endod 2022; 49:4-17. [DOI: 10.1016/j.joen.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 09/05/2022] [Accepted: 09/25/2022] [Indexed: 12/03/2022]
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Wu J, Mao S, Xu L, Qiu D, Wang S, Dong Y. Odontogenic Differentiation Induced by TGF-β1 Binding Peptide-Modified Bioglass. J Dent Res 2022; 101:1190-1197. [PMID: 35411824 DOI: 10.1177/00220345221089238] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Emerging evidence suggests that growth factors are crucial in regenerative endodontic therapy. To achieve the desired effects, the systematic administration of supraphysiologic concentrations of exogenous growth factors is commonly performed, but this is usually associated with high costs, technique, and safety issues. Here, we describe a novel biomaterial that can manipulate endogenous growth factors without the need for adding exogenous growth factors. Transforming growth factor β1 binding peptide (TGFp) was grafted onto the surface of a neutral pH phytic acid-derived bioactive glass (PSC) to synthesize modified bioactive glass (PSC-TGFp). Fourier transform infrared spectroscopy and thermogravimetric analysis results demonstrated that the TGFp was successfully grafted to the surface of the PSC. Scanning electron microscopy and x-ray diffraction showed that PSC-TGFp possessed good in vitro bioactivity. After soaking in simulated body fluid for 24 h, hydroxyapatite formed on the surface of PSC-TGFp. Enzyme-linked immunosorbent assay showed that PSC-TGFp could capture endogenous transforming growth factor β1 from dentin matrix-extracted proteins (DMEP) and release it slowly over 21 d. Cytologic experiments revealed that PSC-TGFp after adsorbing DMEP could enhance the adhesion, migration, viability, and odontogenic differentiation of stem cells from apical papilla. The results highlight that PSC-TGFp may be a promising biomaterial to manipulate endogenous growth factors for regenerative endodontic therapy in the future.
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Affiliation(s)
- J Wu
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - S Mao
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - L Xu
- Beijing National Laboratory for Molecular Sciences, State Key Laboratory of Polymer Physics and Chemistry, Institute of Chemistry, Chinese Academy of Sciences, Beijing, China
| | - D Qiu
- Beijing National Laboratory for Molecular Sciences, State Key Laboratory of Polymer Physics and Chemistry, Institute of Chemistry, Chinese Academy of Sciences, Beijing, China
| | - S Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Y Dong
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
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Dos Reis-Prado AH, Abreu LG, Fagundes RR, Oliveira SC, Bottino MC, Ribeiro-Sobrinho AP, Benetti F. Influence of ethylenediaminetetraacetic acid on regenerative endodontics: a systematic review. Int Endod J 2022; 55:579-612. [PMID: 35305029 DOI: 10.1111/iej.13728] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 03/11/2022] [Accepted: 03/12/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The effects of ethylenediaminetetraacetic acid (EDTA) on regenerative endodontic procedures (REPs) are controversial, because, despite releasing growth factors from dentine, some studies show negative effects on cell behaviour. OBJECTIVES To investigate the influence of the use of EDTA in REP on the growth factors' release, cell behaviour, and tissue regeneration. METHODS A systematic search was conducted (PubMed/Medline, Scopus, Cochrane Library, Web of Science, Embase, OpenGrey, and reference lists) up to February 2021. Only in vivo and in vitro studies evaluating the effects of EDTA on the biological factors of dentine, pulp/periapical tissues, and cell behaviour were eligible. Studies without a control group or available full text were excluded. The growth factors' release was the primary outcome. Risk of bias in the in vitro and in vivo studies was performed according to Joanna Briggs Institute's Checklist and SYRCLE's RoB tool, respectively. RESULTS Of the 1848 articles retrieved, 36 were selected. Among these, 32 were in vitro, three animal studies, and one with both models. The EDTA concentrations ranged from 3%-15%, at different times. Regarding growth factors' release (17 studies), 15 studies found significant transforming growth factor (TGF)-β release after dentine conditioning with EDTA, and most found no influence on vascular endothelial growth factor (VEGF) release. Regarding cell behaviour (26 studies), eight studies showed no influence of EDTA-treated dentine on cell viability; whereas, five, nine, and six studies showed higher cell migration, adhesion, and differentiation, respectively. No influence of EDTA conditioning was observed in animal studies. In vitro studies had a low risk of bias, whereas animal studies had high risk of bias. Meta-analysis was unfeasible. DISCUSSION This review found that EDTA increased TGF-β release and improved cell activity. However, well-designed histological analyses using immature teeth models are needed. CONCLUSIONS High quality in vitro evidence suggests that EDTA-treated dentine positively influences TGF-β release, cell migration, attachment, and differentiation; further research to evaluate its influence on tissue regeneration is necessary due to low methodological quality of the animal studies.
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Affiliation(s)
- A H Dos Reis-Prado
- Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | - L G Abreu
- Child's and Adolescent's Oral Health, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | - R R Fagundes
- Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | - S C Oliveira
- Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | - M C Bottino
- Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, 48109, USA
| | - A P Ribeiro-Sobrinho
- Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | - F Benetti
- Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
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Wolf TG, Krauß-Mironjuk A, Wierichs RJ, Briseño-Marroquín B. Influence of embedding media on the accuracy of working length determination by means of apex locator: an ex vivo study. Sci Rep 2021; 11:3340. [PMID: 33558636 PMCID: PMC7870820 DOI: 10.1038/s41598-021-82942-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 01/27/2021] [Indexed: 11/17/2022] Open
Abstract
The aim of this research was to determine ex vivo the influence on accuracy of five different embedding media, for investigative and educational purposes, and one electronic apex locator. 110 human extracted mature roots of permanent single-rooted human teeth were used. The roots were embedded in alginate, stick sponge, 2% agar–agar and 6% and 12% gelatin. The actual working length to the physiological foramen was determined under a stereo-microscope (16 ×) and the electronic working lengths with the Elements Diagnostic Unit and a K-file ISO 10. The accuracy ranges of the accumulated measurements, when allowing a ± 0.5 mm tolerance, went from 98.2% (6% and 12% gelatin), 93.7% (alginate), 92.8% (2% agar–agar) to 91.7% (sponge). The exact measurements at the physiological foramen ranged from 80.0% (6% gelatin), 76.5% (2% agar–agar), 71.8% (12% gelatin), 68.2% (alginate) to 64.5% (sponge). Although relatively seldom (n = 24), measurements with deviations of more than ± 0.5 mm were also observed; thus, the accuracy of the working length determination results per se can be considered as clinically acceptable. The results of this research allow a recommendation of the investigated embedding media for electronic working length determination models for educational and research purposes in endodontics.
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Affiliation(s)
- Thomas Gerhard Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland. .,Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes-Gutenberg-University Mainz, Mainz, Germany.
| | - Anna Krauß-Mironjuk
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes-Gutenberg-University Mainz, Mainz, Germany
| | - Richard Johannes Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Benjamín Briseño-Marroquín
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.,Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes-Gutenberg-University Mainz, Mainz, Germany
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9
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Sharma S, Nangia D, Saini A, Kumar V, Chawla A, Perumal V, Logani A. Treatment outcome of regenerative endodontic procedures in mature permanent teeth compared to nonsurgical endodontic treatment: A systematic review and meta-analysis. J Conserv Dent 2021; 24:530-538. [PMID: 35558674 PMCID: PMC9089762 DOI: 10.4103/jcd.jcd_535_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/18/2021] [Accepted: 12/21/2021] [Indexed: 11/04/2022] Open
Abstract
Background: Regenerative endodontic procedures (REP) have the advantage of restoring root canal's native defense ability by re-establishing vital pulp-like tissue. This review aims to determine the overall clinical and/or radiographic success rate (O) of REP (I) in mature permanent teeth (P) and to compare it (C) with nonsurgical endodontic treatment (NSET). Materials and Methods: Sources: PubMed, Web of Science, Embase, EBSCO, Cochrane Central Register of Controlled trials, ClinicalTrials.gov, Clinical Trials Registry-India and OpenGrey. Inclusion: Randomized clinical trials and single-arm prospective studies evaluating the treatment outcomes of REP in mature permanent teeth. Exclusion: Incomplete trials/studies, in vitro studies, animal studies, case reports/series, conference proceedings. Cochrane ROB2.0 and ROBINS-I tools were used to assess the risk of bias. Risk difference (R.D.) between NSET and REP was determined by meta-analysis of the randomized clinical trials. The overall success rate of REP was calculated using data from both randomized clinical trials and single-arm prospective studies. Sensitivity analysis and subgroup analysis were performed. Results: Ten studies (n = 552) were included. R.D between REP and NSET was 0.032 (95% C.I: 0.023–0.087; P = 0.258). Overall success rate of REP was 96.0% (95% confidence interval: 94%–98%). No significant difference was found in sensitivity analysis (P = 0.551), or any of the subgroup analysis (P > 0.05). Discussion: A limited number of randomized clinical trials were available, and only two of them had a low risk of bias. Consistent results were obtained in both types of included studies. Conclusion: Based on a limited number of comparative studies, REP has a similar success rate to NSET in mature permanent teeth. Other: Funding: Nil. Registration: PROSPERO (CRD42020204882).
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